Peer Support & Policy Opportunities
Mental Health America/Regional Policy Council
December 12, 2013
ABHW
• The Association for Behavioral Health and Wellness
(ABHW) is the national voice for specialty behavioral
health and wellness companies. ABHW member
companies provide specialty services to treat mental
health, substance use and other behaviors that impact
health. ABHW supports effective federal, state and
accrediting organization policies that ensure specialty
behavioral health organizations (BHOs) can continue to
increase quality, manage costs and promote wellness for
the nearly 125 million people served by our members.
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ABHW Members
Aetna Behavioral Health
Beacon Health Strategies
Cenpatico
Cigna
Healthfirst
MHN
New Directions Behavioral Health
OptumHealth Behavioral Solutions
PerformCare/CBHNP
ValueOptions
Agenda
• Peer Support Services.
• Issues on ABHW’s radar screen/issues for
consideration.
ABHW Members and
Peer Support Services
• Specialty behavioral health organizations increasingly
utilize Peer Support Services and view them as a
valuable component of a comprehensive approach to
wellness.
• Some ABHW member companies have greater
utilization of and experience with PSS services than
others, but across the board, specialty BHOs are eager
to offer PSS, where appropriate and feasible, to the
members they serve.
Peer Support Services (con’t.)
• Challenges that BHOs face in providing Peer Support
Services:
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Reimbursement;
Internal billing systems;
Lack of national credentialing standard;
Need for more qualified peer providers; and
Acceptance.
New Populations
• Medicaid Expansion (up to 21.3M individuals)
– As many as 2.7 million people with mental illness
who are currently uninsured could be added to the
Medicaid rolls (SAMHSA).
– A full Medicaid expansion would provide health
insurance coverage to 17 million people who were
previously uninsured. About 40 percent of this
group – or 6.6 million individuals – with serious or
moderate mental illnesses who are currently
uninsured would obtain health insurance through the
Medicaid expansion between 2014 and 2019.
New Populations (con’t.)
• Health Insurance Exchange
– 8 percent report that they are in fair or poor mental
health (Kaiser Family Foundation March 2011).
– What does the behavioral health benefit look like in
each state?
– Is it adequate?
– Opportunity to revisit.
New Populations (con’t.)
• Criminal Justice
– Prior to coverage expansion under the ACA, an
estimated 10 percent of the jail-involved population
had health insurance when in the community.
– Incarcerated individuals are eligible to be enrolled in
an Exchange if they are still pending disposition of
charges while in jail.
– In 2011, individuals with mental illness made up 33
percent of the average daily jail population (Council of
State Governments Justice Center).
Workforce
• Impact of ACA and MHPAEA.
• SAMHSA and HRSA are working together.
• Federal Government issued $100 million to
bolster the country's mental health programs.
• More needs to be done.
– New Partnerships.
– Telemedicine.
Disruptive Innovation
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New payment models.
New delivery models.
Focus on outcomes over process.
New partnerships.
Parity
• ABHW supports.
• Working to understand and implement the final
regulation.
• Prefer uniform standard for enforcement.